You do not need to leave your room. Remain sitting at your table and listen. Do not even listen, simply wait, be quiet, still and solitary. The world will freely offer itself to you to be unmasked, it has no choice, it will roll in ecstasy at your feet. --FRANZ KAFKA

Monday, August 25, 2008

WHEN DO YOU COMPLAIN?

No one particularly likes a sponge bath, but at the hospital where I underwent my first five surgeries, they made it as pleasant as possible. There was a sweet smelling foamy basin, a soothing back rub with baby lotion, and if I wanted it, that ultimate luxury: a shampoo. A the end of the process, I felt pampered and refreshed.

Thus, I was shocked when an unsmiling aide I’ll call S. showed up to administer my “bath” at my new hospital (a first class institution.) The curtain surrounding my bed still open, she tossed me a wet face cloth, and ordered: “Wash!” A request that she pull the curtain clearly annoyed her, and when that asked for still more, it put her over the edge.

“Soap?” she repeated, as if it were a new concept in bathing. She shuffled out of the room, shaking her head.

I tried to engage S. in conversation, to somehow remind her we were both human, that I understood she hated her job. I, in fact, wasn’t thrilled with my role either. Couldn’t we maybe just be kind to one another?

But S. answered my questions with a grunt, and refused eye contact. After I used her profferred towel, she disappeared without a word.

When Ted came in, he noticed how shoddy her care was even before I mentioned it. She emptied the contents of the foley catheter on top of the bed, and neglected to wear gloves as she moved from one patient to another. The simplest request was met with a glower.

Still, S. and I might have survived each other if I didn’t develop a problem with my pain pump on my second day. When it ceased working, the pain level was intolerable. I pressed my call light, but that wasn’t working either, and my roommmate was out of the room. When S. ambled into the room with her usual scowl, I was thrilled at the sight of her.

However, when I told her about my pain and asked her to get my nurse, S. continued to go about her business as if she hadn’t heard me. “Use your call light,” she said at last, turning her back.

I explained that it wasn’t working, and S. gave it a hasty look. “Try again,” she said, and again turned her back.

As S. moved in and out of the room, I continued to plead my case: the call light wasn’t working; and my pain was nearly unbearable. Could she PLEASE go to the desk and alert my nurse?

The woman, however, was resolute. “There’s nothing wrong with your call light,” she said, as she begrudingly shuffled through the tasks tasks she clearly abhorred.

When my roommate and her nurse returned, S. slithered out of the room before the nurse saw my distress, and confirmed that the light and pain pump were not functioning. She quickly volunteered to get my nurse--but first, she stormed after S.

Though I didn’t tell anyone what had happened with my callous aide., no one seemed surprised the next day when I requested another caregiver. S. was never assigned to me again.

However, I did encounter her in the hallway--and this time, she was the one eager to make eye contact. Now I’m usually a pretty forgiving person, but I wasn’t about to let a woman who’d knowingly left me in pain for over an hour off the hook so easily. Now it was my turn to look away, to refuse to relieve her anxiety. Obviously, she was worried that a complaint that might lead to her termination.

A couple of days later, Ted and I ran into her in the solarium. My first thought was that she was dogging work again, probably avoiding another patient who needed her care. Again, I refused to look her in the eye.

But as we sat there, for a while, I watched her furtively, a heavy woman in her late fifties with deep cut dark circles under her eyes and swollen feet. She clearly had no business working in health care, but she probably didn’t have a lot of choices either.When Ted looked in her direction, she seized on the opportunity. “Beautiful day out there, isn’t it?”

Then she turned to me with an almost touching temerity, exhibiting the broken-toothed smile she'd denied me before, “And how are you feeling? Better, I hope.”

Cynically, I suspected she was only being friendly because she feared receiving what was probably not her first complaint. Maybe her job was even on the line.

I intended to ignore her, but then I thought of the quote from Plato, which had never felt more true: “Be kind because everyone you meet is fighting a hard battle. I hesitated only a moment before I smiled back. “Yes, a little better every day. Thank you.”

And yet even in my moment of amity, I hadn’t entirely ruled out filing a complaint. Though I wasn’t personally angry with S. anymore, I felt a certain responsibility the the next occupants of my bed. Should anyone else be subjected to this kind of care? Was remaining quiet a kindness, or just another example of my greatest flaw: excessive passivity.

I thought it over for the next two days while I was in the hospital, but neither road felt particularly clear or right. In the end, however, I couldn’t forget my moment of empathy for S. as I watched her in the solarium. I thought of her stubby fingernails with their peeling polish, and her tired eyes. In my mind, I stared down at her swollen ankles, and the shoes that were clearly in need of replacement. I remembered that wily, but somehow heartbroken smile. What would happen to her if she really lost her job? Perhaps, I thought, she’d really learned something from her failure with me. Perhaps she wouldn’t treat the next patient the same way. Given the weaknesses of nature she’d exhibited, that might be unlikely, but given my own, I had no choice but to hold out hope.

72 comments:

I hate that you would have to deal with that at the height of pain and vulnerability. I guess I'm jaded enough to think she was being friendly to avoid a formal complaint but in the end If I don't just find myself doing something like submitting one without question, I usually don't. The Wise Woman Way is to fist do nothing. I think the Tao would agree.

I hope you are home soon, Patry. What a hospital war correspondent you've become for some of us.

I can relate to your feelings of compassion for her, and yet, I have to ask myself if a person unwilling or unable to show that same compassion toward the sick and suffering will ever be able to do so? Her neglect and indifference to you is unconscionable and although I know exactly what you mean when you wonder how much she needs this job and how difficult it may be for her to find another, I am more concerned for other patients. I doubt very much that her performance will go unnoticed or unnoted for long. It is a shame, but it is a bigger shame that in your vulnerable state, you weren't shown the compassion you needed and deserved.

All hospitals have incident reports that are supposed to fill out when things are done that are against policy.

The common slang is "writing it up."

I don't know if S. was written up by your roommate's nurse for failing to respond to your needs, but she should have.

I hope she did, because as far as I'm concerned this needs to go in front of the Quality Assurance director. That person has to review all of the incident forms and see if there is a way to reduce or eliminate recurrences of similar incidents in the future.

The problem was that you had a malfunctioning call light, and you were unwilling (or unable) to become what is known as "a screamer" to get the attention you needed.

I know that when I have drawn blood from inpatients that they will occasionally ask me for things I cannot provide. Either they need help going to the bathroom or more pain meds, etc. I will either press their call button or will go to the nurses' station and convey the message. It is common courtesy.

S. did not display the professionalism that is required for her job. If she is not up to the task, then she needs to either change her attitude or change professions.

I would suggest that you mention these incidents to one of your nurses that you respect. It might then obligate that nurse to fill out an incident form, but that is up to her (or him) to decide how to proceed with the knowledge you have provided.

S. might be hanging on to her job by a tattered and frayed thread, but if that is the case then she has only herself to blame.

You and every other patient deserve better care than what you described.

As I'm reading this, Patry, I'm nodding about the wonderful gentle bathing that I've also experienced. Then I'm becoming more and more appalled and angry as I read the rest. Yet, like you, I would hesitate to complain. You are so kind-hearted and hopeful that that woman has learned a lesson, let us hope she did! As Colleen said, you've become our hospital war correspondent. Be home soon! (I love the photo!)

I've faced a similarly difficult situation with a hospital aide recently (I blogged about it here) and I ended up spending an entire night in horrible pain and despair as a result. (FWIW, it was my first night in the hospital in more than 20 years and I'd forgotten how hard you have to work sometimes to advocate for yourself and just cried all night instead).

I would make sure she's not a caregiver who at some point in her career was an inspiration for a Stephen King character. My first response while reading this was to drive to Boston and give her a good ass whoopin'. But then I thought, no, I need to drive up and give her supervisor a good ass whoopin'. A hospital is no place for someone who doesn't like being helpful, much less human. I'm sorry you had to experience that, but maybe she got that ass whoopin' from someone else and it made a difference. Let's hope.

When my mother was in the hospital for her first surgery, she had a terrible experience. The heat control in her room was broken, and she was icy cold, amongst other things. We told the nurse, over and over again, who brought her a thin blanket, but nothing more. While it wasn't immediately cold in the room, for anyone sitting, it became cold quickly. My father and I kept our coats on while sitting by Mum's bed. Mum, for her part, was blue in the lips, hands and feet from the cold (she suffered from Raynaud's too, so the cold was particularly hard on her), and was shivering. It took us three hours to convince the nurse that the thermostat was broken and to get a maintenance man in. She finally summoned someone, who came and fixed it.

Since I had had a terrible experience with a call light after my daughter was born (needing the bathroom at 3:00 a.m. and being unable to go because it had been a high-risk birth and I was still on a mechanical IV that was plugged into the wall -- and then punching the call light for half an hour and getting no response), my sisters and father and I refused to leave my mother alone in her room. We took turns sleeping on slippery fold out chairs at night, and sat with her during the day. It was the only way to ensure she got good care. Not to say that some nurses weren't compassionate, but just that there were enough who hated their job to put my mother at risk of suffering or worse.

No patient should have to suffer needlessly. I love your compassion, but I suspect that aide has a long history of abuse of patients. As others have said, I hope the nurse wrote her up, even if your kind streak prevented you from lodging a formal complaint.

colleen: I usually want to cut everyone a break, can't remember ever complaining about bad service in a restaurant or anywhere else. In the end, letting it go felt right here, too--but I did have doubts because I seriously felt this was a person who shouldn't be working in health care.

lisa: I felt pretty certain that her actions were noticed. That nurse was furious--and as I noted, S. immediately changed her attitude toward me.

l mccabe: I agree with you. This person's shoddy work practices, as well as her lack of compassion, should not be experienced by another patient. I do have a very strong sense that the other nurse "wrote her up." For her sake, I hope she CAN change; and if not, she needs to find a job where the people who are "bothering her" aren't so vulnerable.

marja-leena: Actually, I'm home now, and it is paradise! At times, however, even in a fine hospital with excellent care overall, I DID feel like a war correspondent. (Colleen always finds the right phrase.)

jzr: It's all a matter of balance. Sometimes making a scene is entirely appropriate! Or as someone recently told me: "The nicest patients die first."

jana: I'll make sure to read your blog post.

kevin: You're so right. Cranky bank tellers or waitresses, or clerks might make life less pleasant, but cranky health care is intolerable. I have never appreciated the kind touches, the warm smiles, or the patience of my caregivers more than I did in the hospital. Nor have I ever admired the nursing profession more. Nurses change lives every day. A "bad egg" on the other hand, does a lot of harm.

tk: Thanks for sharing your stories here. They felt very visceral. I felt so sorry to hear of your mother shivering in that cold room (I have Raynaud's too, so I know what it's like) while no one helped. I can't imagine what happens to patients who don't have family to advocate for them. If there is anything "good" about pain, it's that it increases empathy for suffering people everywhere. In the hospital, I couldn't watch the news because the deaths--and especially the horrific injuries in Iraq felt so much more real to me. I couldn't bear to think of what those beautiful young people were enduring.

It's amazing how you can see both the best and worst of humanity within caregivers. I hope S did learn a lesson. Either way, I'm sorry you had this experience--no one deserves such treatment even at the best of times.

As far as having no choice but to hold out hope: it's an interesting word, isn't it? I was recently reading a passage in a book that included a dialogue about just that (Bonds Between Women, China Galland). One woman is telling her friend that hope is the wrong word. She says hope is irrelevant, that it's born of denial. "Hope doesn't walk you through the narrows..... the word is grace--or maybe faith." These words really resonated and I think I agree. We can hope a nurse will treat us with care, or hope that pain goes away, or that someone hears us, or that the world is changing for the better. But does that get us through the narrows? We just have to be open to (have faith that) grace will find us and give us what we need. We have to simply wait.

I think S. heard your words even though you didn't say them out loud. I think she appreciated the way you said them. I think she changed. I think you were both graced.

I used to tell my children that it is good luck to be nice. It is so, isn't it. Reaching inside to a place we don't always know we have. In a health care setting it is so challenging to balance the high tech with high touch. And yet that is what healing is all about.

Another thought--or two: My mother had been in the CICU for most of the last 5 months of her life. I will never forget the kindness of the unit secretary who brought clementines because she knew my mom craved them. However, when my mom was moved to a hospice bed in the same hospital (before we moved her to Hospice House), we stayed around the clock to see that she was respectfully cared for. I stopped the aides who bathed her roughly and without dignity and without regard to her pain. Health care with dignity is a right rather than a privilege, in my mind. I had worked with hospitalized kids and their families and this was much of my job. I am glad you are home. I wish you warm breezes and sunny days.

It is kind of you to have empathy. But, she had none for you. And that is a very important part of her job. Also, I regret that she was so foul that she could not be blessed by your spirit. Working as a waitress I have come to realize that people are often so wrapped in their own misery they cannot find joy. I see my job as a few moments to help them escape and bring them cheer...maybe change their day and thus the day of others around them. Sometimes it works. I think if you ever see her again you should change her day. I wouldn't complain and cost her her job. But I wouldn't accept her taking her miserable life out on you because you represent a job she doesn't like. Maybe if she stopped and enjoyed the people she might learn to like her job.

Mary: What a beautiful message. I like the term "the narrows;" that's what it is has felt like for me. And I like the distinction you draw between hope and grace. I do wish grace for S.

debra: "It's good luck to be nice--" what a wonderful philosophy, and one I truly believe in. Thanks for sharing the stories about your mom.

aimeepalooza: It's funny that you related it to waitressing, because I did, too. On the one hand, I understood how it felt to be tired and to be annoyed by one more request for water or ketchup. On the other hand, I, like you, felt when I couldn't respond with the good cheer my customers deserved, I shouldn't be in the job anymore. I'm sure you are a blessing to all those you serve.

Patry, I know in my heart that the way you dealt with this was right and good and admirable. But another part of me is furious with S and I know that in such a situation I would have been a 'screamer'. While I long to have your compassion, I also feel that such callous, indifferent, inhuman behaviour on the part of one who is supposed to be relied on and caring is just unacceptable, intolerable. I've seen it happen with other so-called 'carers' for my parents and others when in hospital, and I was outraged and said so. No matter what personal problems S may have, your pain and anguish at that moment was greater and there was no excuse for her ignoring it. Sorry for my rant! I'm so glad you're home.

"and neglected to wear gloves as she moved from one patient to another"

Whaaaaaaaaaaa??? This is the sort of thing that *kills people*. Hospital acquired infections are a very serious problem. And yes, leaving patients in pain is very bad, too, albeit not deadly. And no, it shouldn't be up to you to police such people and practices, you have more than enough to worry about in healing and recovering.

Natalie: It seems to be the kind of moral dilemma, for which there is no clear "right" answer. I share your outrage at S's behavior, and in many ways, she deserved to feel and hear that fury. But I couldn't help but pity her--or to wonder what kind of life would produce such heartlessness.

Report her, even now. She gives everyone around her a bad name, passes infection from patient to patient. If not stopped, she will kill someone. Your kindness isn't kindness, it's pity. She needs to be in a different kind of job, immediately. Forgive her, certainly, but don't neglect your responsibility as a human being to demand she be a decent human being.

Imagine the next suffering patient, who is left for hours in pain, unable to move, having a stroke or heart attack. Be kind to them.

so sorry to hear of the bad experiencethere are very few "non-carers" in the medical profession and my experiences have been 99% positiveand - all too often it it those closest to the bottom of the ladder who have shown the most concernthat said - i think plato was right(who'd have thought mickey mouse had such a smart dog) :)

i was in the hospital 2 years ago unable to swallow from my cancer. A rude nurse kept telling me "not to drink" every day and I was even charged 24.00 a day for liquids and I could not swallow???Amazing but true ..sandy

I read this post yesterday, but was too fuming mad that you had been treated so unkindly and while in such a vulnerable position, to leave a coherent comment. I am glad others before me expressed their outrage more eloquently than I could have. It was utterly unconscionable for "S" to not respond with compassion to your needs. It was her job as an employee and as a fellow human.

Robin, I agree: "it was utterly unconscionable for "S" to not respond with compassion to your needs. It was her job as an employee and as a fellow human."

But, though it's hard to believe in this day and age, there are people out there who cannot respond with compassion because they're never experienced it.

All in all, I think Patry's response, perhaps followed up with a note on the questionnaire, was the perfect one. I think a lot of truth about S is contained in the details as Patry wrote them originally.

dawn: Don't worry about it. Spontanaity is the rule here, and it's led me to frequent awkward paragraphs of my own.

floots: Thanks for the smile. 99% of my caregivers have been wonderful, too. It's good to know that most people who choose to work with the sick do it from the best possible motivations. And as I've said, they change lives every day.

sandie: We all come home from the hospital with stories--most of them good. But people remain flawed, and there's always the one...

robin: I only wish you'd been here. Somehow I think you would have straightened her out!

Mary: Unfortunately, it's true. Some people have no compassion in them, and the greatest harm they can do is to rob us of our own. My response, as I said in the post, reflects my own strengths and weaknesses. And though I see Zhoen's point, I also agree with Leslee. Right now I'm pretty overwhelmed with my own recovery, which has not gone well (I've already been sent back to the hospital for an overnight, and may be need to be readmitted tomorrow).

Great Book...Liar's Diary. Great plot, character development; dialogue; Just wonderful. Had me guessing all the way to the end. Thank you for providing me with hours of entertainment. I hope you're on the mend...positive thoughts from Calif are speeding your way.

Kia ora Patry, Your ability to find compassion for this person amazes me, and inspires me. I would still question her functioning in that environment with people at their most vulnerable, and possibly severely damaging someone, and also if she actually came to any realizations herself, other than her job being at risk. Then I read your quote from Plato. This is a hard one. All the best to you Patry. Kia kaha.Rangimarie,Robb

this post stirred me up in a huge way. how dare anyone in the medical profession leave someone who cannot care for herself alone and in pain without any resolution?

when we meet again, you can give me some pointers on gentle kindness to others, and i will give you some on assertive self defense! you know the phrase "too sweet for her own good?" well...

sometimes the result is exactly what we need but don't know how to get it - if she loses her job it might be the thing she most needs in the bigger scheme of things. apparently she is not in the right profession if she has had multiple complaints, enough that one more would terminate her. it could mean that when pushed she might find a job better suited to her needs and certainly that patients would be in safer hands.

i think an official report is certainly reasonable given the circumstances. the next patient could be someone more vulnerable than you. it appears something may have already been done by your roommate's nurse, but you can always speak to the patient advocate's office and ask for advice about how to proceed given your concerns for the well being of the employee as well as for the well being of other patients. i am sure they will advise you appropriately.

ruahines: You know, watching her, I very much felt the weight of her battle. But even before she turned away from me when I was in pain, I believed she was in the wrong job. Kindness and professionalism are just too important to the sick.

dale: I felt angry with S. initially, but that has long dissipated. Dissipated and replaced by hope that she might behave differently in the future. But reading the comments here, thinking of how difficult it is to change our faults even when we want to, and realizing it wasn't one lapse, but many, I ended up mentioning it on my questionnaire.

sky: I've been trying to learn assertive self-defense all my life. To that end, I even took aikido in college--and I do think it helped for a while. Maybe I'll go back to it once I'm ready for the rolling and tumbling again. In the meantime, I look forward to taking a lesson from you!

I am glad to hear that you mentioned these incidents in your questionnaire and that our feedback helped you make up your mind in documenting this substandard care.

You had mentioned your roommate had Mercer. I do not know what that is and did a quick Google search on the topic and found someone else asking about Mercer disease and the answer on that medical bulletin board suggested that they probably meant MRSA. It is sometimes pronounced as Mersa.

I however, still pronounce all the letters of M-R-S-A which is the abbreviation for Methcillin Resistant Staphylococcus Aureus.

My family a few years ago had what is referred to as Community Acquired MRSA as opposed to becoming infected in the hospital environment. One of my nephews contracted this nasty pathogen and at first it was thought to be a spider bite. It wasn't, and he was not specifically told afterward of the culture results.

It kept recurring for months and he had repeated visits to emergency rooms.

Later his brother and my mother contracted the same organism.

They all had to seek emergency medical attention to debride their wounds. My other nephew wound up using crutches for a week because of a wound on his thigh.

I was pissed when I found out what they had and it was only because I as a clinical laboratory scientist insisted that they get a copy of their culture reports and tell me what it said.

For laboratories an identification of MRSA is a critical result and we must notify a caregiver immediately. If we do not properly document who we spoke to then we can get in trouble if they fail to follow up on the case. It also is reported to the hospital epidemiologist.

Another nasty pathogen that is epidemic in hospitals is Clostridium difficile better known as C. diff. It causes nasty diarrhea and is very contagious.

It is not an option in this day and age to pick and choose whether or not you follow the standards of changing gloves and washing your hands between patients.

Linda: Thanks for the information about MRSA--and for the spelling correction. I know it is a dreaded organism in hospitals, but beyond that, I wasn't too well-informed. Your family stories just scared the hell out of me! Hopefully, I've passed the danger point for contracting it.

I knew before finishing this post the comments would be intriguing! My favorite is Mary's questioning whether or not it's hope that gets us "through the narrows." I realized just this morning through an exercise on character that what I find most heroic about the heroic people in my life (and yes, you're one of them, Patry) is their shared ability to act with immense grace in the face of life's most daunting challenges. And I believe I'm drawn to such people because I hope to harbor some of that grace so it can find me and give me what I need when I truly need it. As Mary also noted, at such times we can hope and pray but sometimes we have to "simply wait." As always, you handled this whole situation (including writing this post and responding to every comment) with much grace, kiddo. Hugs and prayers that you never have to be tested like that again, K.

k: I knew I would get some great comments, and some constructive dissension when I first wrote this post. You all always make me think and grow. As far as grace goes, yours is evident in everything you write.

You are a very kind-hearted person, Patry, to have seen this other person's suffering underneath her rough exterior.

Still, it sounds like S. may be in the wrong profession, especially if she cannot get your broken call button fixed and insists on being mean.

I have heard other stories like this, sadly enough. When people are sick in hospital, they really need to be taken care of! For those people paid to take care of the ill, this has to be one of their top priorities.

I'm sure you weren't the only one S. has been mean to (unfortunately). I'm glad to hear you're home and on the mend.

kg: The job S. does is a difficult and important one that should be rewarded with higher pay and more respect than it is. But in spite of that, all the other aides I met were cheerful and professional. As zhoen says, someone like S. makes everyone around her look bad.

Sue: I know you would! I still remember how much I admired you when you fought for our taxi. (I'd probably still be standing on that street, waiting...) As far as the youtube video goes, I'd love to see that one!

I think this woman is cruel and I would not want her to be inflicted upon me if I were ill. It is one thing to feel compasion for her, but it is quite another to allow her to run around infecting already ill people with her unwashed hands and compounding the suffering of others with her cruelty. I think not reporting this is the same thing as looking the other way when someone is being abused. It's the same thing. You were abused and you are choosing to put whatever her problems may be ahead of your own pain. Why must her pain be more important than yours? Where is your compassion for yourself? I think you deserve compassion and good treatment.

Forget it! She'll treat the next patient the same way. This woman obviously hates her work and has no respect for other people. No, her swollen ankles and such don't mean a thing to me: she chose this profession and should be professional under *all* circumstances. I've had the pleasure of meeting nurses like that and reported their conduct immediately. Her attitude was unprofessional and sadistic and she should not be allowed to expose other people to her 'I don't give a damn' attitude. Grrrrrrrrrrrrr!

I was/am horrified by your experience, angered and frightened by it. I am glad you are home "in paradise" and grateful for your beautiful words.

dawn's comment really struck me:

"why do I tolerate sub-quality care/customer service than I would expect for someone else?"

I, and no doubt you, would fight tooth and nail for a child in pain, but when it comes to ourselves, we think of the other person first.

in your situation, though I would probably have screamed or called out if I could, I would also have empathy for 'S'. in fact, after initial anger, the more awful a person is, the more I feel sorry for him.her (often counter-productively).

but then I get to extrapolating --and this is NOT about you, but an effort to understand human nature which you inspire in me.

the essence of humanity is empathy, yet care for the self can be construed as self pity, which one wants to avoid. but when is that denial of self itself a kind of vanity? is pride more powerful than self love? when does one take a stand for the self and when does one put the welfare of others first?

I think of Ghandi, the Dalai Lama, Christ...and the idea that love for others is love for god, or goodness.

and yet, does that leave advocacy for the self entirely to others? is that childish? martyrdom? what if we do not want to be saints?

I have no answers, but these are such important questions, especially in these times, and I thank you for helping me think about them.

Dear Patry, I am thinking of you and sending you positive thoughts for a speedy recovery. I'm sure this blog and what you have written about so well in this post, will in the end be the means to right any wrongs.Have loved reading about your red shoes and seeing your beautiful granddaughters ... and it has to be said, neither you nor your husband look nearly old enough to be grandparents!!!

Gerry: So true. Fortunately, in my experience, caregivers like S. are very much the exception. Most people in health care do an amazing job.

r: You would have had her head!

Anon: Thanks for sharing your thoughts and your wisdom. I see your point, but an abuse victim usually has an emotional tie with their abuser that makes them return for more. It's not really forgiveness; it's co-dependence, no? My compassion for S. was much more dispassionate. (Though I forgave her, I also requested another aide for the rest of my stay. The knowing look I got in response led me to believe her co-workers were well aware of her conduct.) For me (a shy type who flunked assertiveness training class) that was pretty good! Ideally, I probably should have filed a complaint immediately on behalf of her next "victims", but I was pretty sick myself. At that point, keeping her away from me was all I could handle. In any case, thank you for your thoughtful message--and I agree with you. S. wasn't just negligent; she was cruel!

deborah: I wish you were there!! Thanks for sharing your fire. As I said before, readers ultimately made a difference in how I handled this situation. Whether anything will be done about S. remains to be seen. Since I will be having another surgery in 3 months, and will probably be on the same floor, I'll report back

maryanne: You raise some important questions--the kind that were very much on my mind when I wrote the post. I really believe that I was seeking the wisdom and counsel of the amazing readers of this blog when I wrote the post--and I got it. I also got a wonderfully expanded, thoughtful discussion.

Anonymous and several other commenters really made me think: If it had been one of my children lying in the bed, I would have screamed at S. and made as much noise to her supervisors as I could--and it's unlikely I would have forgiven her. (I'm still angry at the fifth grade son Josh in front of the class twenty years ago--even though he forgot the incident long ago.In that case, I not only reported the teacher to the principal; I wrote letters to every member of the school board.) But that's a mother's instinct. I've never been quite as good at sticking up for myself...

Kay: Thank you! Not only have the blog readers been a source of wise counsel, the love and support has been incredible. Even when my recovery stalls, I feel like the most blessed of women. Thanks, too, for saying we look too young to be grandparents! I used to FEEL too young, too, but lately, I'm feeling more like their great-grandmother. They keep wondering where their energetic playmate has gone.

Whatever you decide, you did what you needed to do at the time. That was your first duty. And I think that writing the post, thinking about the pros and cons of the situation and asking, perhaps indirectly, for the input of others before reaching a final decision (perhaps via the questionnaire) shows your desire to be fair to yourself, other patients and S herself.

In a case like this, with many serious factors to consider, reflecting and taking the time you need is evidence of common sense and wisdom, even. In my book anyway!

I agree with those who said you should even now report her, and here's why:

She is indeed in the wrong job. Not only is she endangering life and causing misery to others, she is clearly unhappy in the job herself. One way to look at is that if you get her fired, she may well end up somewere better - both better for herself and for others.

I agree with those who said you did what you needed to do at the time. I believe that we are all catalysts, that our actions affect others around us in ways we cannot predict or know. What you did then was the right thing at the time. Doesn't mean you can't follow up with a report on that questionnaire.

Lastly, I believe that something vital has been forgotten in the medical world. Nursing care. That doesn't mean just injections and medication and changing dressings, it means care of the patient, body and soul. It means that tender sponge bath, a listening ear, perhaps brushing a patient's hair or providing other small comforts - like the clementines.

Personally, I believe that nursing care is almost as important in recovery as the drugs and the surgeries, and it's tragic that good nursing care is so rare these days. I know the time and money isn't there, but a smile and kind word cost nothing.

jay: I agree with many of the ccomments here, too--and they literally changed me. You make an interesting point that hasn't been made before though. S. would probably be happier in another job--one that doesn't involve dealing with people. As an ex-waitress, I understand burn-out, and know how the same requests over and over can wear on you. But I always believed that once you can't deliver with a smile, it's time to quit.

I'm so very sorry, you went through so much pain, with so little compassion shown to you...I think it may happen far too eaily and often in health care, that people can grow jaded - they build a sort of wall between them and the people they're supposed to be serving - and no one is served by it, not even the person who built the wall to protect themselves...

You are such a kind, compassionate and merciful soul, Patry - I pray that at least some of the mercy that you showed her, will penetrate through the walls she's built around her, so she can show mercy to others again...

And most of all - I pray you never have to experience such pain again!

How well you have captured the ambiguity that plagues us all . . . what is the right thing to do when treated cruelly. I am so sorry you had to endure such pain for so long, but once again, your experiences give us much to ponder.

I love your Plato quote. It is so easy to fail when life asks much of us. I think perhaps S recognized her cruelty and wanted to make amends ... and to change. Perhaps you gave her the opportunity to do so. I like to think that is what happened.

tinker: It's easy for all of us to become jaded--especially when you're constantly besieged by other people's needs. (I remember that from my waitressing days.) But I always vowed that I would find a new profession if I got so burned out that I couldn't treat people the way they deserve to be treated. Thank you for all your good thoughts and prayers--and especially for your friendship.

beryl: I'm not surprised that you see it that way--and when I think back on her cautious smile in the solarium, I think you might be right.

So sorry you had to endure that. Your compassion for that woman - who didn't deserve it, but you're right - we never know what people are going through - is remarkable. You're such an inspiration and I'm always thrilled to come here and find something new. xo

About Me

My second novel, THE ORPHANS OF RACE POINT, an epic love story that spans several decades and is tested by murder, betrayal, faith, and destiny, set amidst the vibrant Portuguese community in Provincetown, Massachusetts will be published by Harper on January 7, 2014.